| NPI | 1598651259 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA101849) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2025-06-17 | 
| Last Update Date | 2025-09-02 |