| NPI | 1255579207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 20174) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 20174) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2016-10-10 |