| NPI | 1023481363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009236) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 7833) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2024-04-11 |