| NPI | 1790038024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22632) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2022-06-01 |