| NPI | 1134647241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 311725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54865) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2021-04-27 |