| NPI | 1669578605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1436) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1436) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2018-03-08 |