| NPI | 1942876172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61839) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5310) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2023-01-06 |