| NPI | 1528189339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19696) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001862) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-06-02 |