| NPI | 1477755007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MG1635044) |
| 363A00000X Physician Assistant (Licence: PA OA002644) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2023-03-31 |