| NPI | 1275747677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 19569) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.002403) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-01-03 |