| NPI | 1669343935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007413) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA067018) |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2026-05-20 |