| NPI | 1184637654 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6908) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA17769) | 
| Enumeration Date | 2006-08-14 | 
| Last Update Date | 2025-05-12 |