| NPI | 1689650871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0002127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA30076) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2019-05-06 |