| NPI | 1336541648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55338) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA174510) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60668549) | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-06-19 |