| NPI | 1538553128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55386) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005701) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2019-06-11 |