| NPI | 1306481270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7140) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 133862) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2025-09-26 |