| NPI | 1871943555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005338) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06743) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-09-20 |