| NPI | 1720384837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53112) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2011001606) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2016-03-29 |