| NPI | 1912294588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 52385) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02736) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-04-19 |