| NPI | 1053373886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA 14901) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: WA PA61306617) |
| 208D00000X General Practice (Licence: CA 14901) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-10-23 |