| NPI | 1992045165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 64558) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2026-01-07 |