| NPI | 1952684094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055155) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002731) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2020-11-11 |