| NPI | 1407987324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1850) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA AP1850) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2017-04-12 |