| NPI | 1881488385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 8571260) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-07-29 |