| NPI | 1962098368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15583) |
| Enumeration Date | 2020-12-19 |
| Last Update Date | 2025-10-27 |