| NPI | 1528895778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-164892) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2025-12-09 |