| NPI | 1902632748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010360) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-12-14 |