| NPI | 1528818549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1203407)  | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2024-03-25 | 
| Last Update Date | 2025-07-30 |