| NPI | 1467878264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1811) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2021-07-31 |