| NPI | 1124202379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD C0001427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01427) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2021-08-20 |