| NPI | 1083016125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57881) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9108190) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2020-03-06 |