| NPI | 1174075329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15184) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00305) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2025-06-03 |