| NPI | 1063006377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8299) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2304247) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-10-07 |