| NPI | 1568124584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063184) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2022-08-09 |