| NPI | 1356650360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9120043) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3062) |
| Enumeration Date | 2010-09-26 |
| Last Update Date | 2025-07-29 |