| NPI | 1255664405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5054) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA20480) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2024-05-19 |