| NPI | 1609568625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MP8302060) |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2025-04-01 |