| NPI | 1275077182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058788) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004014) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2020-08-30 |