| NPI | 1710457239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060377) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004703) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2020-02-19 |