| NPI | 1861097073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063922) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 42681) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA063922) | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2023-01-26 |