| NPI | 1033961859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065374) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2026-06-26 |