| NPI | 1871320010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065934) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006999) |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-09-19 |