| NPI | 1730818089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008920) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C09123) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-02-09 |