| NPI | 1154667921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9119115) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22760) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2025-04-04 |