| NPI | 1699159657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52637) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60593874) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2021-06-01 |