| NPI | 1043811409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58812) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5285-23) | 
| Enumeration Date | 2020-11-03 | 
| Last Update Date | 2024-10-14 |