| NPI | 1316597628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005011) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2022-03-22 |