| NPI | 1144491101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: MA BOH-22-BAP-02) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA AP2485) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2022-06-10 |