| NPI | 1972947430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01808) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-02-28 |