| NPI | 1750631867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004716) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2021-03-03 |