| NPI | 1073853602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9106608) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2023-09-26 |