| NPI | 1205346228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008493) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008906) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2025-07-11 |