| NPI | 1073856969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0005012) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA52058) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2015-08-10 |