| NPI | 1750050225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 14111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006953) |
| 363A00000X Physician Assistant (Licence: TX PA18040) | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2026-06-09 |