| NPI | 1114684693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63881) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: FL PA9115318.) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2024-07-15 |