| NPI | 1922481498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057681) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07288) |
| 363A00000X Physician Assistant (Licence: PA OA003877) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-12-09 |