| NPI | 1861970592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12756) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2024-02-29 |