| NPI | 1215113741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA737) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2013-04-02 |