| NPI | 1720962335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 17225) |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-10-10 |