| NPI | 1922400480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003396) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2018-01-12 |