| NPI | 1366879306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 23217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2017041798) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2020-12-10 |