| NPI | 1538898531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065845) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009203) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-02-19 |