| NPI | 1902308802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA007536) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064942) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2025-11-14 |