| NPI | 1104936350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5097) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA P17918) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-07-22 |