| NPI | 1639100068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9379) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA000849) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-07-17 |