| NPI | 1982980645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9105101) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 21236) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2018-05-24 |