| NPI | 1730580051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 126364) |
| 363A00000X Physician Assistant (Licence: SD 0932) | |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2025-09-23 |