| NPI | 1689770323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-67291) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001573) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-04-09 |