| NPI | 1164396024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA067370) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2026-01-13 |