| NPI | 1578957585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005716) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05657) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-02-26 |