| NPI | 1548745417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004944) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: PA MA060440) | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2025-11-24 |