| NPI | 1750922100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061190) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2025-07-02 |