| NPI | 1538567912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57885) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA031102) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2022-01-05 |