| NPI | 1750720850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55834) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC TL1934) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-10-03 |