| NPI | 1609118074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52586) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4672) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2023-03-08 |