| NPI | 1477965085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004357) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2023-07-03 |