| NPI | 1285038166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05326) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2020-08-13 |