| NPI | 1699965178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053728) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA053728) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2025-06-25 |