| NPI | 1174042964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007194) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059258) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2019-08-01 |