| NPI | 1215409297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11147) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56345) |
| Enumeration Date | 2019-01-01 |
| Last Update Date | 2025-02-20 |