| NPI | 1356892418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9109765) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58451) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2021-03-16 |