| NPI | 1982070058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 101678) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3613-23) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2025-12-10 |