| NPI | 1265898613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006035) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA53093) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2022-01-03 |