| NPI | 1063050953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007422) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2021-05-13 |