| NPI | 1043597990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005340) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003657) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2019-02-11 |