| NPI | 1013259381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 493526) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-01-27 |