| NPI | 1346623923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA173918) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2018-11-29 |