| NPI | 1063004927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA0055458) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2023-10-02 |