| NPI | 1003283672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06573) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001005772) |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2023-03-17 |