| NPI | 1003538356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4538) |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2025-09-25 |