| NPI | 1134017320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PR 002590PA) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL TPPA978) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-07-31 |