| NPI | 1215056114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001086) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22218) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2015-06-12 |