| NPI | 1235244302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60061) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1500805) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-09-20 |