| NPI | 1568877405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA61849) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3738-23) |
| 363A00000X Physician Assistant (Licence: NC 0010-05142) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-11-30 |