| NPI | 1295867919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA-16300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9101798) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |