| NPI | 1770090201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: CA PA55234) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-06-18 |