| NPI | 1003875253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5994) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA13970) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-01-11 |