| NPI | 1790046548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002324) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2025-08-25 |