| NPI | 1962836346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55288) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4686) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-07-24 |