| NPI | 1700529666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12528) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2026-07-31 |