| NPI | 1174047625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006482) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: MD C0006482) | |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2023-08-03 |