| NPI | 1487888053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065301) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003820) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2024-09-03 |