| NPI | 1598439333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063641) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114786) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2023-03-09 |