| NPI | 1184759649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8397) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 11877) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2025-07-02 |