| NPI | 1851399968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0003478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051209) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2024-04-19 |