| NPI | 1699438523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005836) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2023-12-01 |