| NPI | 1316283179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055173) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2025-08-06 |