| NPI | 1649991050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12555) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2024-10-02 |