| NPI | 1023025749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA000982) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2018-07-19 |