| NPI | 1346498565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA057122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19787) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2015-07-15 |