| NPI | 1679960371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5761) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 52355) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2016-09-19 |