| NPI | 1730600446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6405) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |