| NPI | 1659885713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059494) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004328) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2021-08-11 |