| NPI | 1255535282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA17204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2002-0037) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2012-04-23 |