| NPI | 1184307621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 4271480) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| 2471C3402X Radiologic Technologist, Radiography | |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2026-06-09 |