| NPI | 1548838196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8201) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1185092) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2022-02-23 |