| NPI | 1811311244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MD8907086) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07969) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2025-10-24 |