| NPI | 1093057788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22846) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2019-07-22 |