| NPI | 1255367322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 812) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC A812) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 812) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-08-29 |