| NPI | 1063793818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57834) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4926) |
| 363A00000X Physician Assistant (Licence: MT 117353) | |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2022-11-07 |