| NPI | 1588317937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2636) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA60685) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2023-12-11 |