| NPI | 1538192356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MT MED-PAC-LIC-558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 558) |
| 363A00000X Physician Assistant (Licence: MD C0003014) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-05-14 |