| NPI | 1285351080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4643) |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2026-05-06 |