| NPI | 1386001683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06182) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057759) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2022-10-31 |