| NPI | 1992250245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA0623115) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006079) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2025-06-27 |