| NPI | 1043883093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60085) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2025-07-31 |