| NPI | 1508264862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 093723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0949) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2025-06-16 |