| NPI | 1700547114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8909) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-09-29 |