| NPI | 1275295495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005883) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |