| NPI | 1205672946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 137884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 3363) |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2026-07-15 |