| NPI | 1649705971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059067) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004279) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2025-09-15 |