| NPI | 1003747494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 9012-23) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2026-05-26 |
| Last Update Date | 2026-08-31 |