| NPI | 1649746801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008820) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9454) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2023-05-25 |