| NPI | 1639701592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007927) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007722) |
| Enumeration Date | 2020-02-09 |
| Last Update Date | 2021-11-08 |