| NPI | 1215129689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52524) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3663) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2019-09-04 |