| NPI | 1568208460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009634) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2025-10-27 |