| NPI | 1427007459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1003) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-01-15 |