| NPI | 1801493507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065402) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2025-03-27 |