| NPI | 1295285773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058708) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2021-11-12 |