| NPI | 1568742096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1771) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 21772) |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2020-06-29 |