| NPI | 1154864916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1151131) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2022-07-13 |