| NPI | 1225348154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2674) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2025-0072) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2025-12-15 |