| NPI | 1548731144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004715) |
| Enumeration Date | 2018-12-08 |
| Last Update Date | 2018-12-08 |