| NPI | 1962100883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0009217) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2026-01-21 |