| NPI | 1265444582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56386) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2194) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-01-22 |