| NPI | 1306197819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22326) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0041) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2019-08-07 |