| NPI | 1649996059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2859) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 117476) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2025-10-14 |