| NPI | 1982132973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059215) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004221) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2024-07-03 |