| NPI | 1588439236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C09230) |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2025-08-12 |