| NPI | 1407472699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4733) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2025-09-25 |