| NPI | 1487053252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005475) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2022-05-31 |