| NPI | 1346869005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007957) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061398) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2021-09-17 |