| NPI | 1639464027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02777) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2020-01-24 |