| NPI | 1568697126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 6053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053151) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2025-11-14 |