| NPI | 1053928044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009537) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009931) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2025-07-13 |