| NPI | 1881095032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057121) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MAO57121) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2020-08-31 |