| NPI | 1245891720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004866) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-09-13 |