| NPI | 1336694850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003861) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2020-08-28 |