| NPI | 1831808930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064084) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006313) |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2026-01-22 |