| NPI | 1154791838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5605) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61030232) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2025-07-16 |