| NPI | 1700134343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C04868) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2018-11-09 |