| NPI | 1255698379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1962) |
| 363A00000X Physician Assistant (Licence: GA 006404) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2025-10-30 |