| NPI | 1356932867 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3879)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GU 129)  | 
| Enumeration Date | 2021-01-27 | 
| Last Update Date | 2024-06-26 |