| NPI | 1770849663 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52397) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52387) | 
| Enumeration Date | 2012-04-05 | 
| Last Update Date | 2023-10-19 |