| NPI | 1861965790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007512) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007035) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2024-02-27 |