| NPI | 1881170926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059858) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004510) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2021-03-05 |