| NPI | 1114281839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03612) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2023-10-02 |