| NPI | 1144636408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056950) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003327) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2019-04-15 |