| NPI | 1891265948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 094795) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2021-07-29 |