| NPI | 1487949707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2733) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2020-11-11 |