| NPI | 1942038294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA102169) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9120074) |
| 363A00000X Physician Assistant (Licence: TX PA18097) | |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-10-29 |