| NPI | 1437615853 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010847) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12571) | 
| 363A00000X Physician Assistant (Licence: MN 13472) | |
| Enumeration Date | 2019-02-11 | 
| Last Update Date | 2025-08-11 |