| NPI | 1760023444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN282810) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-07-18 |