| NPI | 1811688823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009223) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110009432) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2026-03-12 |