| NPI | 1992229371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005859) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2024-01-05 |