| NPI | 1497129860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58603) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601007540) |
| Enumeration Date | 2015-11-22 |
| Last Update Date | 2021-03-18 |