| NPI | 1225410129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA53531) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA20150046) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2022-01-06 |