| NPI | 1508064593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA pa22010) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA00443) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA053051) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-01-03 |