| NPI | 1962944355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL PA-1187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1187) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2019-01-02 |