| NPI | 1275259616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 3252) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008656) |
| 363A00000X Physician Assistant (Licence: IA 131225) | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2025-05-05 |