| NPI | 1841951282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110009153) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2023-03-14 |