| NPI | 1376868190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C03907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003245) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2021-05-26 |