| NPI | 1124971346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-16061) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: NC 001016061) |
| Enumeration Date | 2026-02-17 |
| Last Update Date | 2026-05-27 |