| NPI | 1942746144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C07838) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54128) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 54128) | |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2025-08-04 |