| NPI | 1649146739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA067263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007500) |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-15 |