| NPI | 1174964183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7527) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2022-07-21 |