| NPI | 1912698242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009496) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: VA B201802040) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2024-05-03 |