| NPI | 1689262586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007869) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062169) |
| 363A00000X Physician Assistant (Licence: PA OA005451) | |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-03-10 |