| NPI | 1679235915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA007155) |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2025-11-24 |