| NPI | 1972010726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06680) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA066840) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA066840) | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2026-09-30 |