| NPI | 1063931426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06777) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6856) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2018-08-22 |