| NPI | 1639572365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022007255) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51904) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2022-07-11 |