| NPI | 1225327794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22782) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0063) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2019-07-11 |