| NPI | 1437868759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200002182) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2022048969) | 
| Enumeration Date | 2022-11-15 | 
| Last Update Date | 2025-08-07 |