| NPI | 1720641566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007071) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-04-18 |