| NPI | 1376966119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005308) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9107712) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2023-05-30 |