| NPI | 1063854669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 65363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 11722) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2024-11-11 |