| NPI | 1578276481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065071) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-13429) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2025-06-19 |