| NPI | 1780054619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1331) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52791) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-07-20 |