| NPI | 1245560515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 21932) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3908) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2023-03-07 |