| NPI | 1184067993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062766) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05615) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2023-03-08 |