| NPI | 1356390934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA950) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001000084) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2025-11-14 |