| NPI | 1780086470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MW5116252) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2024-02-13 |