| NPI | 1639896061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA066863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116608) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2025-11-07 |