| NPI | 1528469210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1742) |
| 363A00000X Physician Assistant (Licence: WA 60505744) | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2022-12-07 |