| NPI | 1033548151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-5598) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2520) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2025-10-15 |