| NPI | 1124484696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 3160) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8347-23) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2025-08-25 |