| NPI | 1639731011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7112) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2021-07-01 |