| NPI | 1134643182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8870) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54701) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-01-21 |