| NPI | 1962782599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4937) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2019-05-23 |