| NPI | 1699306159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007559) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10449) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2021-11-16 |