| NPI | 1497196760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056240) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003074) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2022-11-08 |