| NPI | 1053975904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56905) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 56905) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2025-12-18 |