| NPI | 1558669820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22337) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003553) |
| 363A00000X Physician Assistant (Licence: AZ 4836) | |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2012-07-25 |