| NPI | 1164891073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003624) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057811) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2025-02-26 |