| NPI | 1750358438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1711-023) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-09-26 |