| NPI | 1285695445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57936) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057542) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 57936) | |
| 363A00000X Physician Assistant (Licence: MA PA1713) | |
| 363AM0700X Physician Assistant, Medical (Licence: MA 1713) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-12-19 |