| NPI | 1073862355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06441) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22505) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2016-10-14 |