| NPI | 1578766234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5054) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2014-07-23 |