| NPI | 1295440444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 117191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 117191) |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2025-05-27 |