| NPI | 1184366270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.010016RX) |
| 363A00000X Physician Assistant (Licence: MO 2025054193) | |
| 363A00000X Physician Assistant (Licence: TX PA15391) | |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2026-01-28 |