| NPI | 1467883231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09256) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51243) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2020-10-26 |