| NPI | 1952768798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54340) |
| 363A00000X Physician Assistant (Licence: GA 7849) | |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2026-04-23 |