| NPI | 1982296216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006546) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2023-08-31 |