| NPI | 1952017519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 1180756) |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2023-03-20 |