| NPI | 1023382074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 52589) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA 52589) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2023-11-14 |