| NPI | 1417411190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA56493) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56493) |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2019-01-26 |