| NPI | 1023560059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058523) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003913) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2020-01-07 |