| NPI | 1578934261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52892) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12196) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2022-01-03 |