| NPI | 1992116891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0110004579) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-004579) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0005426) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2021-06-04 |