| NPI | 1295265981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101311) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57082) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2025-04-30 |