| NPI | 1477281871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14981) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 11032) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2025-01-16 |