| NPI | 1730723362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12144) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 5615) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2025-11-20 |