| NPI | 1184016792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003483) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2021-01-26 |