| NPI | 1285206243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8209) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2022-10-17 |