| NPI | 1992861439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56035) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003409) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2018-10-05 |