| NPI | 1992279590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062657) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006794) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2024-01-23 |