| NPI | 1487012399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064387) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MA PA6379) | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2023-08-07 |