| 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 |