| NPI | 1689260382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062165) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007835) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2022-03-18 |