| NPI | 1578539763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 2003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17040) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2009-01-08 |