| NPI | 1972047728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006012) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2024-01-24 |