| NPI | 1891030193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055761) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2022-04-28 |