| 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 |