| NPI | 1497530125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA064908) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006629) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2025-07-18 |