| NPI | 1356962211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58446) |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2025-11-18 |