| NPI | 1720868748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-13763) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-08-16 |