| NPI | 1528524782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08868) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2024-07-29 |