| NPI | 1174126080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 59469) |
| 363AS0400X Physician Assistant Surgical (Licence: CA 59469) | |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2024-08-19 |