| NPI | 1972563252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052399) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052399) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-04-26 |