| NPI | 1871331256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA067243) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007495) |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2025-10-15 |