| NPI | 1174752752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3804) |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2024-03-12 |