| NPI | 1417540287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062166) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005449) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |