| NPI | 1215412689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11684) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060138) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2024-09-22 |