| NPI | 1447811328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063547) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07326) |
| Enumeration Date | 2019-06-22 |
| Last Update Date | 2023-10-24 |