| NPI | 1245854348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9644) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2022-07-20 |