| NPI | 1801624788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14505) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010233) |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-11-19 |