| NPI | 1295247336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5903) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6420) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2026-02-05 |