| NPI | 1972022192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3186) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2020-03-17 |