| NPI | 1518696889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063577) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-07-22 |