| NPI | 1215533559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061612) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2021-02-22 |