| NPI | 1497231062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61436) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059871) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2023-01-25 |