| NPI | 1235975889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006915) |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-11-21 |