| NPI | 1326209123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19781) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA19781) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA19781) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-10-24 |