| NPI | 1518395201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MD056648) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2017-04-17 |