| NPI | 1881240315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061761) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006884) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2022-10-17 |