| NPI | 1861918880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059310) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004262) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2025-07-05 |