| NPI | 1740851906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C08012) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2023-06-14 |