| NPI | 1083212625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0974) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1825) |
| 363A00000X Physician Assistant (Licence: MN 14228) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9113712) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA061930) | |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2026-01-22 |