| NPI | 1548454101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA23196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005256) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2017-08-02 |