| NPI | 1295348811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 3668) |
| 363A00000X Physician Assistant (Licence: VA 0110010017) | |
| 363A00000X Physician Assistant (Licence: NC 0010-12557) | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2025-03-25 |