| NPI | 1003865759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001876L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002198) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2024-07-18 |