| NPI | 1902320427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 8395) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 4473-154) |
| 363A00000X Physician Assistant (Licence: WI 8395-23) | |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2025-08-07 |