| NPI | 1821577727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7187) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2019-03-07 |