| NPI | 1720457161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007420) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007420) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2024-11-05 |