| NPI | 1811780414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 132844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 3285) |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-09-30 |