| NPI | 1952857641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003920) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2025-04-07 |