| NPI | 1821616764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8197-23) |
| 363AM0700X Physician Assistant, Medical (Licence: MN 14582) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL TPPA755) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2025-12-08 |