| NPI | 1770923369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA52452) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056162) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2016-05-13 |