| NPI | 1922335611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002405) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2018-04-24 |