| NPI | 1881354769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063077) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA0063077) |
| 363A00000X Physician Assistant (Licence: PA OA005893) | |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2023-08-09 |