| NPI | 1255519708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 10012133) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2025-07-01 |