| NPI | 1255573234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21565) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1477) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2021-11-02 |