| NPI | 1457721144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA ma057654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003572) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-12-11 |