| NPI | 1427484187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056478) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA056478) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2016-05-25 |