| NPI | 1821705039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-009082) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2023-01-20 |