| NPI | 1205083524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21694) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053297) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2021-11-29 |