| NPI | 1003681370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 7094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 5118) |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2025-06-16 |