| NPI | 1932674611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004619) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2023-09-02 |