| NPI | 1609516889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 14728) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-08-11 |