| NPI | 1891269858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08365) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113475) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2022-03-28 |