| NPI | 1598775173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 158505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA PA12926) |
| 363A00000X Physician Assistant (Licence: CA 12926) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-03-31 |