| NPI | 1487280566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07622) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2022-06-08 |