| NPI | 1083294201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5895) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007837) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-09-09 |