| NPI | 1154038164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006261) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |