| NPI | 1699401919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2025-06-13 |