| NPI | 1386260842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066615) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA58612) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA58612) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2025-09-09 |