| NPI | 1265959274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7008) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 17867) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2019-10-29 |