| NPI | 1649753427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8690) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55962) |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2025-06-10 |