| NPI | 1942511555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21007) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2016-11-09 |