| NPI | 1063949980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06517) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-06-08 |