| NPI | 1821774423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 3222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 131213) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-04-23 |