| NPI | 1699897165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 17629) |
| 363A00000X Physician Assistant (Licence: CA PA17629) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-03-09 |