| NPI | 1861930356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004073) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2022-01-11 |