| NPI | 1851062012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-16130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 11485) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2026-01-20 |