| NPI | 1740899178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007371) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2024-11-04 |