| NPI | 1083197107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06942) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9475) |
| 363A00000X Physician Assistant (Licence: VA 0110-006704) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2024-06-13 |