| NPI | 1912980491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110840800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-840800) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2025-08-15 |