| NPI | 1770986606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057029) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003356) |
| 363A00000X Physician Assistant (Licence: MD C0005583) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-01-27 |