| NPI | 1326219965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19671) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA 19671) |
| 363AS0400X Physician Assistant Surgical (Licence: CA PA 19671) | |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2014-01-21 |