| NPI | 1013508258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11965) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 2848) |
| Enumeration Date | 2021-01-31 |
| Last Update Date | 2026-05-22 |