| NPI | 1639772643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11016) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 268598) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2025-05-14 |