| NPI | 1699490516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2869) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2024-04-12 |