| NPI | 1619500691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0007509) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA006883) | |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110009710) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2025-08-25 |