| NPI | 1194981290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053491) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 0A002355) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2022-09-01 |