| NPI | 1780158733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006742) |
| Enumeration Date | 2019-01-13 |
| Last Update Date | 2022-04-11 |