| NPI | 1174752976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004001) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 5535) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2025-05-13 |