| NPI | 1588117766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007112) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058269) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2019-04-22 |