| NPI | 1962100909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4775) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1200472) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2025-03-20 |