| NPI | 1881252104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006729) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 312961) |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2023-08-08 |