| NPI | 1306517354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062919) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MK6784816) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2025-03-11 |