| NPI | 1487497319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006886) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-09-11 |