| NPI | 1609556679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0009748) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0012194) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2025-04-16 |