| NPI | 1710746953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA065714) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2025-07-03 |