| NPI | 1407520091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0010063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063240) |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2025-09-04 |