| NPI | 1356999494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57851) |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2023-11-28 |