| NPI | 1093055303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 59732) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03880) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2024-02-15 |