| NPI | 1861955114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6839) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA PA6839) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-06-27 |