| NPI | 1346579471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3886) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1518) |
| Enumeration Date | 2009-12-20 |
| Last Update Date | 2020-11-02 |