| NPI | 1487036695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05711) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001005711) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2026-08-04 |