| NPI | 1710500848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58136) |
| Enumeration Date | 2020-05-23 |
| Last Update Date | 2023-04-10 |