| NPI | 1851067334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008114) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-10-13 |