| NPI | 1205403284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63464) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11339) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2024-06-10 |