| NPI | 1255840013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA54921) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA54921) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2021-12-14 |