| NPI | 1336925486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009738) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2024-05-06 |