| NPI | 1528570991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2511) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55182) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2023-10-05 |