| NPI | 1578868329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2140) |
| 363AM0700X Physician Assistant Medical (Licence: GA 006044) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2013-08-12 |