| NPI | 1649748336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3301) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2025-04-08 |