| NPI | 1124769757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063362) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009674) |
| 363A00000X Physician Assistant (Licence: VA 0110010586) | |
| 363A00000X Physician Assistant (Licence: PA OA006015) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2024-12-25 |