| NPI | 1508217613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56829) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2016030310) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-07-08 |