| NPI | 1932670163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12774) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006683) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2023-04-05 |