| NPI | 1639287352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA456) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 000456) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-08-28 |