| NPI | 1679908362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53896) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007015) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2019-05-24 |