| NPI | 1649059197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 4871647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 1200715) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2025-03-10 |