| NPI | 1073322871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15556) |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2026-08-17 |