| NPI | 1750784781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064120) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005568) |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2023-10-05 |