| NPI | 1013510825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10766) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2024-02-29 |