| NPI | 1972953792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008735) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2021-02-11 |