| NPI | 1760956247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025010701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00413) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2025-07-29 |