| NPI | 1669135968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant (Licence: NC 0010-11693) | |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2025-02-26 |