| NPI | 1184111551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 57797) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111231) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2020-02-10 |