| NPI | 1417290917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51310) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04024) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-05-14 |