| NPI | 1053468074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008350) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 10078) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-09-15 |