| NPI | 1417466327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 90211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54953) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2021-04-02 |