| NPI | 1528803368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006820) |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2025-02-19 |