| NPI | 1629724588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08871) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD 207Q00000X) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2023-05-17 |