| NPI | 1689492365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C50012280) |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2025-07-22 |