| NPI | 1740477207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19382) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2019-07-08 |