| NPI | 1558784512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55300) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2026-02-12 |