| NPI | 1003500596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA064888) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006619) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2025-07-18 |