| NPI | 1407205560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53444)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA ms3915533)  | 
| Enumeration Date | 2016-06-09 | 
| Last Update Date | 2020-07-06 |