| NPI | 1144638917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056972) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003337) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2022-08-09 |