| NPI | 1215305628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057776) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003610) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2019-08-05 |