| NPI | 1679978357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057136) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003384) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |