| NPI | 1639067291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025011399) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025011399) |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-07-10 |