| NPI | 1447703525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9454) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: ME PA1616) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2023-07-19 |