| NPI | 1053378810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 3644) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53396) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2024-06-18 |