| NPI | 1023046364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003978) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17830) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2013-02-11 |