| NPI | 1942679568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057857) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7501) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2025-04-14 |