| NPI | 1265156780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63502) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA063956) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2024-05-13 |