| NPI | 1982960340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055445) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 51687) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-02-13 |