| NPI | 1871004036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059426) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004299) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2019-09-09 |