| NPI | 1063722486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 22753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005946) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2022-08-08 |