| NPI | 1306485073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061323) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2025-12-29 |