| NPI | 1487106183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56762) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3747) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2019-05-14 |