| NPI | 1972194850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009285) |
| Additional Taxonomies | 208800000X Urology (Licence: VA 0110009285) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2023-08-11 |