| NPI | 1336682236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-112203) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54024) |
| Enumeration Date | 2016-11-24 |
| Last Update Date | 2023-11-27 |