| NPI | 1306328323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9229) |
| 363A00000X Physician Assistant (Licence: CA 9229) | |
| 363AM0700X Physician Assistant, Medical (Licence: IA 093289) | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2023-04-24 |