| NPI | 1598472136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 119975) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 119975) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2026-05-07 |