| NPI | 1558119776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100731) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1206434) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-07-15 |