| NPI | 1801671524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066326) |
| 363A00000X Physician Assistant (Licence: WV 3136) | |
| 363A00000X Physician Assistant (Licence: CA PA67322) | |
| 363A00000X Physician Assistant (Licence: IA 135066) | |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2026-03-23 |