| NPI | 1902671696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110009694) |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2025-08-15 |