| NPI | 1710617972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110011010) |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2025-08-05 |