| NPI | 1710242557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C04839) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060606) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2024-01-04 |