| NPI | 1568462869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09266) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19734) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-11-06 |