| NPI | 1497073811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20862) |
| 363A00000X Physician Assistant (Licence: KS 15-01382) | |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2019-08-06 |