| NPI | 1881328375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063699) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063699) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2025-08-01 |