| NPI | 1447622832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06926) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52808) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2021-08-07 |