| NPI | 1205376720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59598) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2017005525) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2023-08-03 |