| NPI | 1306145602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007002) |
| 363A00000X Physician Assistant (Licence: SC MPA.1924 TL) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 001002635) | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2025-09-02 |