| NPI | 1811487192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008470) |
| Enumeration Date | 2018-05-13 |
| Last Update Date | 2024-02-16 |