| NPI | 1043970627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062779) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005775) |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2022-02-14 |