| NPI | 1720369846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008969) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1098227) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2025-03-03 |