| NPI | 1083865026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002905) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110002905) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2021-08-13 |