| NPI | 1649352725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C01734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001102) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2024-03-21 |