| NPI | 1770987281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA171544) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2019-04-17 |