| NPI | 1043460645 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009228) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 15380) | 
| Enumeration Date | 2008-09-19 | 
| Last Update Date | 2025-06-12 |