| NPI | 1396021762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52125) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA030805) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2014-11-03 |