| NPI | 1972858397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IA 002285) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 51391) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2025-08-08 |