| NPI | 1013559871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113918) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2025-08-13 |