| NPI | 1275913907 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057603) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003849) | 
| 363A00000X Physician Assistant (Licence: FL PA9115737) | |
| Enumeration Date | 2015-06-08 | 
| Last Update Date | 2025-01-29 |