| NPI | 1730601949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006512) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06512) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-10-24 |