| NPI | 1932695764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C07208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 7130) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA063837) | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2025-06-23 |