| NPI | 1144867219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061292) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MA061292) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA061292) | |
| Enumeration Date | 2019-12-07 |
| Last Update Date | 2020-01-13 |