| NPI | 1932497518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21575) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA166318) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2014-03-14 |