| NPI | 1891129516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51955) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99058491A) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2015-07-16 |