| NPI | 1649672346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006833) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2022-09-26 |