| NPI | 1851855357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009165) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009029) |
| 363A00000X Physician Assistant (Licence: VA 0110007647) | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-12-16 |