| NPI | 1356507628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2619) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2020-10-15 |