| NPI | 1205243318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057004) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007141) |
| 363A00000X Physician Assistant (Licence: PA MB3276082) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2025-02-26 |