| NPI | 1164909040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60748) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10385) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2023-05-01 |