| NPI | 1770290371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009988) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001012642) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2025-01-21 |