| NPI | 1568755627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054406) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2017-06-01 |