| NPI | 1003992900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18668) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-12-19 |