| NPI | 1649764978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MA PA6695) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2019-03-06 |