| NPI | 1699575787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011593) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2026-02-24 |