| NPI | 1679130025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 61218) |
| 363A00000X Physician Assistant (Licence: SC 5277) | |
| 363AM0700X Physician Assistant, Medical (Licence: GA 9511) | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2024-08-28 |