| NPI | 1497279046 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56156)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002368A)  | 
| Enumeration Date | 2017-07-26 | 
| Last Update Date | 2019-01-02 |