| NPI | 1023638137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8189) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2022-09-07 |