| NPI | 1093374480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008876) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA004867) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-06-18 |