| NPI | 1063005551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MA061554) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2023-09-20 |