| NPI | 1871914432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003219) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2020-08-20 |