| NPI | 1073164166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63945) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7185) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2025-03-21 |