| NPI | 1689306326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006141) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2023-09-27 |