| NPI | 1508287467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3824) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2306) |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2025-12-01 |