| NPI | 1942612684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009657) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2082) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2024-02-29 |