| NPI | 1588801708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3942) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA3942) | |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2019-02-26 |