| NPI | 1558921593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060756) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004861) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2020-04-02 |