| NPI | 1174926455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003422) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA0547177) | |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2024-03-26 |