| NPI | 1033487145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 23143) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006151) |
| 363A00000X Physician Assistant (Licence: WA 60530735) | |
| Enumeration Date | 2011-12-03 |
| Last Update Date | 2016-10-28 |