| NPI | 1306385224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9103196) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |