| NPI | 1740998178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7177-23) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2025-09-29 |