| NPI | 1215286778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51532) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03702) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2023-08-06 |