| NPI | 1609055292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 187826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD 1079771) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2026-07-10 |