| NPI | 1134591621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56745) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 103678) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-08-14 |