| NPI | 1215371745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22865) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA PA22865) |
| 363A00000X Physician Assistant (Licence: NV PA2454) | |
| 363A00000X Physician Assistant (Licence: IL 085004622) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2021-08-12 |