| NPI | 1023212446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA13577) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004465) |
| 363AM0700X Physician Assistant Medical (Licence: IA PA002170) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-01-04 |