| NPI | 1952779647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057828) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003631) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2020-12-30 |