| NPI | 1306578083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: CA PA65833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA65833) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2025-12-09 |