| NPI | 1942825773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58406) |
| 363A00000X Physician Assistant (Licence: HI AMD-1285) | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2026-03-12 |