| NPI | 1922774553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15512) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2025-07-31 |