| NPI | 1629486006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3355-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54293) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2022-06-15 |