| NPI | 1891714424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05870) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-07-24 |