| NPI | 1467690420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA-055882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20067) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2013-03-07 |