| NPI | 1699478057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008369RX) |
| 363A00000X Physician Assistant (Licence: UT 14268583-1206) | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2026-02-13 |