| NPI | 1649990839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 115283) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2025-05-12 |