| NPI | 1437662194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-89261) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54944) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2025-04-09 |