| NPI | 1225003007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4730) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA16645) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2014-02-03 |