| 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) |
| 363A00000X Physician Assistant (Licence: PA MA067268) | |
| 363A00000X Physician Assistant (Licence: SC 6120) | |
| 363A00000X Physician Assistant (Licence: VA 110011404) | |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2025-10-29 |