| NPI | 1902178197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA1455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA52430) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2021-01-05 |