| NPI | 1831520220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056277) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011737) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2025-09-10 |