| NPI | 1003066804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101969) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002909) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2025-09-22 |