| NPI | 1407057714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052019) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002030) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-09-11 |