| NPI | 1346510815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055428) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22015) |
| 363A00000X Physician Assistant (Licence: PA OA003286) | |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2015-06-11 |