| NPI | 1902416605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007382) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-007382) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2022-03-31 |