| NPI | 1457830150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55847) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2022-10-11 |