| NPI | 1174130421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64865) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7126) |
| 363A00000X Physician Assistant (Licence: ID 1271076) | |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2025-09-04 |