| NPI | 1831643725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 329209) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53607) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2025-01-29 |