| NPI | 1144973942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13130) |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2025-11-03 |