| NPI | 1609419126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13634) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2025-06-17 |