| NPI | 1700228434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7013) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05624) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2022-04-12 |