| NPI | 1306197975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA51610) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2018-03-17 |