| NPI | 1801438635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07682) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2020-10-07 |