| NPI | 1215200043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 6026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004677) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2025-11-18 |