| NPI | 1922571173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA56424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08628) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-12-21 |