| NPI | 1740731637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 56069) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 8135) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2018-10-22 |