| NPI | 1134675978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 4880) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005428) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2025-05-19 |