| NPI | 1124090162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051866) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2023-02-08 |