| NPI | 1366050791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11524) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001011524) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2025-10-20 |