| NPI | 1861689390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53416) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2007028606) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2017-02-07 |