| NPI | 1295107589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005968) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2020-04-16 |