| NPI | 1083091979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055845) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002974) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2024-04-03 |