| NPI | 1851990170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7830) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2024-01-04 |