| NPI | 1821547878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06712) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058530) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2023-02-03 |