| NPI | 1639778277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA61745) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 6709) |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2024-11-14 |