| NPI | 1942784301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060196) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2024-03-15 |