| NPI | 1568108330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064361) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006395) |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2025-01-15 |