| NPI | 1932566874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53154) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2026-01-29 |