| NPI | 1235613449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 192559) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY PT787) |
| 363A00000X Physician Assistant (Licence: OR PA217373) | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2026-04-20 |