| NPI | 1831649144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063329) |
| 363A00000X Physician Assistant (Licence: VA 0110011478) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2025-12-15 |