| NPI | 1568892925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005544) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2024-08-01 |