| NPI | 1891242541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10466051-1206) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-04-05 |