| NPI | 1194207928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001248) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2021-03-25 |