| NPI | 1760907497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059165) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2020-01-17 |