| NPI | 1730413931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 23172) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054036) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA003093) | |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2014-10-23 |