| NPI | 1215124854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19356) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2024-10-15 |