| NPI | 1730759309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13044) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11635) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2025-07-14 |