| NPI | 1255635751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8538) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21300) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2022-03-14 |