| NPI | 1952547002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA56210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01625) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2021-04-22 |