| NPI | 1548969413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 208393) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2026-01-27 |