| NPI | 1760204887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065919) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006993) |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2025-01-09 |