| NPI | 1255225652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007294) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA066799) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-08-11 |