| NPI | 1538653571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4437) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2022-03-28 |