| NPI | 1184467797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066440) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006899) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2025-07-15 |