| NPI | 1871543132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2549) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-14 |