| NPI | 1114598950 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4429) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11421) | 
| Enumeration Date | 2021-07-02 | 
| Last Update Date | 2025-09-08 |