| NPI | 1275780850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56254) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2009017891) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2022-10-27 |