| NPI | 1629403647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53423) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001564A) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2018-01-17 |