| NPI | 1710387907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN217066) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2017-02-06 |