| NPI | 1861495798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20473) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 1412) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2014-08-11 |