| NPI | 1306475975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15235) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9604) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-07-24 |