| NPI | 1508405739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA061237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MM5832123) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2025-03-31 |