| NPI | 1710180260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA895) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2025-08-13 |