| NPI | 1407581630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100890) |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2025-07-11 |