| NPI | 1750843538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113688) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-08-02 |