| NPI | 1861125494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12653) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2025-08-29 |