| NPI | 1699167676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004777) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2025-11-20 |