| NPI | 1275010407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004533) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |