| NPI | 1508393406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005965) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-02-17 |