| NPI | 1215319918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15690) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05829) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-09-17 |