| NPI | 1578617908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0003459) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053797) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2021-05-14 |