| NPI | 1306893102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-426) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 426) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2026-06-24 |